Substance Use and Mental Disorders: Early Detection ...

1 Substance Use and Mental disorders : Early Detection , prevention and Treatment February 26, 2014 A Healthy People 2020 Progress Review Howard K. Koh, MD, MPH Assistant Secretary for Health Department of Health and Human Services Overview and Presenters Chair Howard K. Koh, MD, MPH, Assistant Secretary for Health Department of Health and Human Services Presentations Rebecca Hines, MHS, Chief, Health Promotion Statistics Branch National Center for Health Statistics, Centers for Disease Control and prevention Philip Wang, MD, DrPH Deputy Director, National Institute of Mental Health, National Institutes of Health Jack Stein, PhD, Director.

2 Office of Science Policy and Communications National Institute on Drug Abuse, National Institutes of Health Frances M. Harding, Director, Center for Substance Abuse prevention Substance Abuse and Mental Health Services Administration Community Highlight Connie Smith, prevention Branch Manager, Division of Behavioral Health Kentucky Department for Behavioral Health Healthy People 2020 Evolves 5 Burden of Substance Abuse Estimated costs Excessive drinking - $ billion (2006) Illicit drug use - $193+ billion (2007) Usage Current binge alcohol users - about million people aged 12 or older (2012)

3 Current users of illicit drugs - million people aged 12 or older (2012) Impact of Mental disorders A leading cause of: Disability Absenteeism and lost productivity in the workplace Mental disorders affect nearly 44 million adults (2012) $300 billion spent on treatment (2012) Depression is associated with the development of hypertension, heart disease, diabetes, and stroke. 6 SOURCE: Prince M, Patel V, Shekhar S, et al. LANCET 2007:370(9590):859-877; Sing M, Hill S, Puffer L. DHHS Publication. No. SMA 01-3542. Rockville, MD: CMHS, Substance Abuse and Mental Health Services Administration.

4 2001.; National Survey on Drug Use and Health, SAMHSA, 2012.: Insel T. Assessing the state of America s Mental health system. Testimony before the Committee on Health, Education, Labor, and Pensions for the United States Senate. 2013.; Wassertheil-Smoller S, Shumaker S, Ockene J, et al. Arch Intern Med 2004:(164):289-298. Carnethon M, Biggs M, Barzilay J, et al. Arch Intern Med. 2007:(167):802-807. Jonas BS, Mussolino ME. Psycho Med 2000:(62): 463-71. Rebecca Hines, MHS Chief, Health Promotion Statistics Branch National Center for Health Statistics Centers for Disease Control and prevention Early Detection , prevention & Treatment Tracking the nation s progress Mental Health/ Mental disorders Depression Suicide Serious Mental Illness (SMI) Substance Use Excessive alcohol use Illicit drug use Presentation Overview 8 Tracking the Nation s Progress 15 HP2020 Measurable Mental Health and Mental disorders Objectives.

5 2 Targets met 1 Improving 3 Little or No change 5 Getting worse 4 Baseline data only 34 HP2020 Measurable Substance Abuse Objectives: 7 Targets met 7 Improving 8 Little or No change 8 Getting worse 4 Baseline data only NOTES: The Substance Abuse Topic Area also contains 8 Informational objectives and 2 Developmental objectives. Measurable objectives are defined as having at least one data point currently available, and anticipate additional data points throughout the decade to track progress. Informational objectives, are a subset of measurable objectives that do not have a target.

6 Developmental objectives lack baseline data and targets. 9 Impact of Mental disorders A leading cause of: Disability Absenteeism and lost productivity in the workplace Mental disorders affect nearly 44 million adults (2012) About $300 billion spent on treatment (2012) Depression is associated with the development of heart disease, diabetes, and stroke SOURCES: Prince M, et al. LANCET 2007:370(9590):859-877; Sing M, et al. DHHS Publication. No. SMA 01-3542. Rockville, MD: CMHS, Substance Abuse and Mental Health Services Administration. 2001; National Survey on Drug Use and Health, SAMHSA, 2012: Insel T.

7 Assessing the state of America s Mental health system. Testimony before the Committee on Health, Education, Labor, and Pensions for the United States Senate. 2013.; Centers for Disease Control and prevention , Heart-Healthy and Stroke-Free: A Social Environment Handbook. accessed on 2/10/14 at: 10 Mental Illness Prevalence, 2012 NOTE: Data are for adults aged 18 years and over. Any Mental Illness (AMI) Serious Mental Illness (SMI) Major Depressive Episodes (MDE) National Survey on Drug Use and Health (NSDUH) is a critical Mental health data source 11 SOURCE: National Survey on Drug Use and Health (NSDUH), SAMHSA.

8 Depression and Suicide Over 16 million adults reported major depressive episode (2012) Lifetime major depression for women is over double that of men Depression is a risk factor for suicide attempts More than 38,000 Americans died by suicide in 2010 2nd for leading cause of death for ages 25-34 and 3rd for ages 10-14 and 15-24 10th leading cause of death for all ages SOURCES: National Survey on Drug Use and Health, SAMSHA; Centers for Disease Control and prevention , accessed on 2/10/14 at: ; Centers for Disease Control and prevention , accessed on 2/10/14 at: ;Center for Disease Control and prevention , Web-based Injury Statistics Query and Reporting System, 12 Obj.

9 Decrease desired 05101520 TotalFemaleMale2 or more racesHispanicNative HawaiianWhiteAmerican IndianBlackAsian12-1314-1516-17 Major Depressive Episode, Adolescents, 2012 NOTES: I = 95% confidence interval. Data are for adolescents aged 12-17 years who reported having a Major Depressive Episode (MDE) in the past 12 months. American Indian includes Alaska Native. Native Hawaiian includes other Pacific Islander. The categories black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. SOURCE: National Survey on Drug Use and Health (NSDUH), SAMHSA.

10 HP2020 Target: * Age (years) Percent 13 Obj. Decrease desired 051015 TotalFemaleMale2 or more racesAmerican IndianWhiteHispanicBlackAsianMajor Depressive Episode, Adults, 2012 NOTES: I = 95% confidence interval. Data are for the proportion of adults aged 18 and over who experienced a Major Depressive Episode in the past 12 months. American Indian includes Alaska Native. The categories black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. SOURCE: National Survey on Drug Use and Health (NSDUH), SAMHSA. HP2020 Target: Percent 14 012345 TotalFemaleMale20092010 Visits to Primary Care Physicians that Included Depression Screening, Adults NOTES: I = 95% confidence interval.